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How exercise resets your body clock and improves sleep patterns

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How exercise resets your body clock and improves sleep patterns

Exercise improves sleep quality and helps treat sleep disorders by regulating circadian rhythms, reducing stress, and enhancing physiological functions like melatonin production and autonomic balance.

Review: The impact of exercise on sleep and sleep disorders. Image Credit: Lysenko Andrii / Shutterstock

In a recent review article published in the journal npj Biological Timing and Sleep, researchers summarized the research on how exercise, or structured physical activity, improves sleep quality, both for those with sleep disorders and healthy individuals. They highlighted that the effects of exercise on sleep are influenced by factors such as an individual’s age, sex, fitness level, and the type, timing, and intensity of exercise.

Types of Exercise

Exercise is any form of repetitive, planned, and structured physical activity. Aerobic exercise involves activities that use the body’s large muscle groups, increasing the heart rate and the amount of oxygen a person uses. Swimming, cycling, and walking are forms of aerobic exercise.

While aerobic exercise improves cardiovascular health, anaerobic exercise, which includes sprinting and weight training, builds muscle strength and mass. Meanwhile, stretching exercises focus on improving an individual’s range of motion, but the evidence is mixed regarding whether or not they can prevent injuries.

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Dynamic exercise involves moving joints and appears to have health benefits in the long term, including improved blood flow and lower blood pressure. However, static exercise occurs when muscles are activated without movement and can increase blood pressure significantly but build strength over time. The journal article also noted that these different forms of exercise may have distinct effects on sleep, with aerobic exercise generally providing the most benefits for sleep quality.

Advantages of Exercise

Exercise is critical to regulating weight, as it prevents excessive gain and can support weight loss by burning calories and balancing calorie expenditure and intake. It decreases the risk of diabetes, hypertension, and depression. Regular exercise also improves cardiovascular health, improves heart recovery, and decreases the resting heart rate.

Beyond physical benefits, exercise also improves mood and energy. It increases energy levels by improving the delivery of nutrients and oxygen to the tissues. Meanwhile, exercise improves mood, reduces stress, and enhances relaxation, particularly if it takes the form of activities that a person enjoys. Research has shown that exercise can reduce levels of cortisol, a stress hormone linked to sleep disturbances, while increasing melatonin, the hormone that regulates sleep cycles.

Not getting adequate amounts of exercise has been linked to chronic illnesses such as diabetes, cancer, and heart disease, which have become leading causes of global mortality.

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How Exercise Improves Sleep

In healthy individuals, exercise improves sleep efficiency, which is defined as the ratio of time a person spends sleeping to the total time they spend in bed.

Specifically, exercise between four and eight hours before going to bed can reduce wakefulness during sleep and help people fall asleep faster. However, the review emphasized that exercising less than four hours before bedtime may delay melatonin release and increase body temperature, potentially making it harder to fall asleep. Regular exercise also improves overall sleep quality and helps people sleep longer.

Over time, exercise improves sleep hygiene, namely the habits that help people sleep well. This leads to stable sleep-wake cycles and improves the regulation of the body’s circadian rhythms. Because exercise acts as a “zeitgeber” (a factor that influences the body’s biological clock), it can help reset disrupted circadian rhythms, particularly in individuals who experience sleep disturbances due to shift work or jet lag.

Exercise can also indirectly improve sleep by reducing stress and enhancing mood. Regular and consistent exercise reduces stress, depression, and anxiety. By reducing the heart rate, exercise calms the body, facilitating sleep. It also regulates hormones like cortisol and melatonin, which are linked to sleep patterns.

Treating Sleep-Related Disorders

Researchers have studied the benefits of exercise for alleviating sleep disorders. Exercise has psychological benefits, reducing the emotional stress and anxiety associated with disordered sleep. It can also reduce sleep-disordered breathing and improve autonomic and hormonal imbalances that worsen sleep quality.

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Regarding specific sleep disorders, people experiencing insomnia can benefit from moderate-intensity aerobic exercise, which improves the onset of sleep, reduces the time spent awake, and enhances the overall sleep quality. The review also noted that exercise may be more effective when combined with sleep hygiene interventions, such as maintaining a consistent bedtime and avoiding stimulants before sleep.

Another condition that can hamper sleep quality is restless leg syndrome (RLS), a neurological condition that causes an uncontrollable urge to move the legs. Aerobic exercise can also reduce symptoms of RLS, including throbbing, aching, and itching in the legs. The study highlighted that the benefits of exercise for RLS may be due to improved blood circulation and neuromuscular function.

For people with sleep apnea, which causes breathing to stop and start repeatedly during sleep, researchers recommend combining weight loss with exercise to reduce the severity of the condition and improve functioning and wakefulness during the day. Importantly, the review found that even in the absence of significant weight loss, regular exercise can improve sleep apnea symptoms by enhancing autonomic nervous system regulation and reducing inflammation.

Conclusions

While existing studies on the relationship between exercise and sleep are promising, researchers identified ways to apply these findings and avenues for future investigations.

Long-term studies are needed to understand how different durations, intensities, and types of exercise impact sleep patterns. Diverse populations should be included to identify tailored and effective interventions for different demographic groups. The review also called for more research into the molecular mechanisms underlying the effects of exercise on sleep, such as its impact on brain function and immune responses.

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There is still much that is not known about the physiological mechanisms that underpin exercise’s impacts on sleep quality and circadian rhythms, particularly among those with chronic sleep disorders. The systemic and molecular effects of exercise on sleep also need more exploration.

Current research can be applied to interventions to improve the health of athletes and the general public. For athletes, optimizing sleep is crucial for recovery and performance, and the review suggested integrating personalized sleep-monitoring protocols into training programs.

Physical activity should be promoted as a non-pharmacological intervention for the general public, but clear guidelines regarding intensity, frequency, and timing should be provided for different age groups. The researchers stressed the importance of personalized exercise prescriptions that account for an individual’s age, fitness level, and existing sleep disturbances to maximize benefits.

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I’ve been doing the bird dog exercise instead of planks to improve my core strength – it’s even better for beginners

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I’ve been doing the bird dog exercise instead of planks to improve my core strength – it’s even better for beginners

While the bird dog exercise mainly works the core muscles, improving stability and strength, it also targets the lower back, shoulders, hamstrings, and glutes, making it one of the better full-body exercises you can do.

Over the years, I’ve done plank after plank and seen few benefits. It’s just not the exercise for me. I can hold the position for about a minute before everything starts shaking and my forehead starts sweating. Even with practice, it feels torturous.

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?


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Boutique Fitness Is Redefining How Americans Work Out




















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I pushed myself too hard at the gym – and ended up in the hospital

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I pushed myself too hard at the gym – and ended up in the hospital

In January 2025, I attended my first bootcamp class.

I had spent the day hunched over my laptop, anxious and craving an intense workout that would dispel my worries. I booked the class at a nearby gym, and the five-star reviews promised the all-consuming exercise I wanted: “Militant style instructor, but very motivating,” read one. Another: “Hardest workout of my life; extremely rewarding.”

The gym was no-frills – just a room with a mirror. After a standard warm-up, we did four sets of lateral shuffle push-ups across the floor, interspersed with standing, weight-bearing exercises.

When my turn came, I dropped to plank position and started doing steady, shallow reps, focusing on my form.

But caution soon fell away. Upbeat music was booming and someone was always advancing beside me. When the instructor encouraged us to lower all the way down, I obeyed, even though my form suffered. I had rarely done more than a handful of pushups at a time, and in the final set, I was exhausted, collapsing on every rep and barely prying my torso off the floor.

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The rest of class was a blur. I became nauseated, told the instructor I needed to pause, and stepped outside to suck cold winter air into my lungs.

Back in the studio, I sat on the sidelines and waited for the dizziness to recede before slinking to my spot for the core section and cooldown.

Later that night, I felt what I thought was typical post-workout muscle soreness. I was satisfied; the ache was proof of a successful workout.

But the next day, lifting my arms to wash my face was exhausting. Searing pain kept me awake that night. Two days after the class, my arms were so stiff I couldn’t raise them more than a few inches, even to brush my teeth.

When I Googled my symptoms – pain, weakness and a new one, dark urine – something frightening came up: exertional rhabdomyolysis, a condition wherein extreme exercise causes muscle cell contents to flood the bloodstream, potentially overwhelming the kidneys. One article warned that debilitating pain after a new, intense activity was a sign to visit the emergency room.

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I went to the ER but suspected I was overreacting. After all, the internet always offers the worst possibility.

Doctors use bloodwork to test for exertional rhabdomyolysis; typically, they diagnose it if a patient has too much of a muscle enzyme called creatine kinase (CK) in their blood – at least 1,000 units per liter, or five times the normal range. However, there is little consensus on this number, says Dr Barry Boden, an orthopaedic surgeon at The Orthopaedic Center in Maryland, who specializes in sports medicine. Some recent guidelines suggest that only higher amounts – as much as 10,000 units – warrant diagnosis and inpatient treatment.

My CK count was so high the machine in the emergency room couldn’t measure it; a nurse had to do a second blood draw and send it to a more precise lab. They put me on an IV drip and eventually reported the exact number: 57,000.

Thus began my seven-day hospital stay. My mom and sister traded shifts, acting as my arms for the week – scrubbing my teeth, feeding me, washing my face. I had never felt so helpless and irresponsible. What had I done to myself?

What is exertional rhabdomyolysis?

Normally, during exercise, muscles tear a little and then rebuild. There may be a little extra CK in a person’s blood as a result, which healthy kidneys can filter out.

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But excessive exercise can harm muscle cells so much that their contents – including CK and a protein called myoglobin – overload the system. “When the cell membrane starts to break down, the chemicals within the muscle cells start to get released, which can cause damage to other organs around the body,” said Boden. “ If there’s enough of those chemicals from the muscle that reach the kidney, it can cause damage to the kidney.”

The symptoms are muscle pain (even while at rest), weakness and dark urine, though few people experience all three. Treatment involves early and aggressive administration of IV fluids to help the kidneys filter the toxins. It’s possible to manage a mild case with at-home oral hydration, but it’s always important to consult a doctor because mild symptoms don’t always mean low CK elevation, said Dr Petr Schlegel, a CrossFit trainer and professor at the department of physical education and sports at the University of Hradec Králové in the Czech Republic.

Exertional rhabdomyolysis is dangerous and fatal in very rare cases; researchers estimate that 10% of patients develop acute kidney injury (AKI), and some suffer other serious complications.

How common is exertional rhabdomyolysis?

Before I had rhabdomyolysis, I had never heard of it; I thought the worst that could come from a workout was a broken bone or a regurgitated lunch. I now know it can happen to anyone, although people with certain conditions, such as sickle-cell trait and hypokalemia, are predisposed. Despite the common misconception that only unfit people can get it, even elite athletes are susceptible.

 “Anybody can get it – anybody that’s pushed to an extreme, taking a big jump in their exercise level, or doing something they’re not used to doing,” said Boden. “Everybody has muscles, and if the muscles are damaged enough, you can develop rhabdomyolysis.”

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Boden authored a study estimating there were over 40,000 exertional rhabdomyolysis cases in US hospitals from 2000 to 2019. But he said it’s impossible to get a precise count, as no organization collects the data.

This number is likely an underestimate, as the condition is probably under-reported, said Schlegel. Since the symptoms closely resemble those of delayed onset muscle soreness – the normal ache people expect after a workout – individuals may not seek care.

Data indicate exertional rhabdomyolysis is on the rise. In Norway, Australia and the US, researchers have observed an increase in hospital records between the 2000s and 2010s. This year, hospitals in a Canadian province reported a surge in cases.

Researchers suspect the popularity of high-intensity workouts is behind the rise. They are efficient and produce measurable progress, but are risky if misused, said Schlegel: “Evidence suggests that high-intensity exercise, especially when combining strength and endurance elements, carries the greatest potential to induce [exertional rhabdomyolysis].”

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Can you prevent exertional rhabdomyolysis?

Prevention guidance has been pretty consistent since the earliest studies from the 1960s: vary exercises to avoid overloading one muscle group, incorporate rest, and gradually build intensity when starting something new or after time off.

Starting low is especially important when targeting large muscle groups – such as biceps, triceps and quads. “It’s that hyperintense going from zero to 100, really intense workouts of large muscle groups, that puts people at risk,” said Dr Bryant Walrod, a sports medicine physician and the head team physician for the Ohio State Buckeyes. Weight matters, but so do reps; an outrageous number of low-weight exercises or calisthenics – hundreds of pushups or squats, for example – is the trigger in many cases. Walrod also advises doing a different kind of workout from one day to the next.

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Eccentric exercises like push-ups – where muscles lengthen – are particularly likely to cause injury. In a 2024 article about how to prevent rhabdomyolysis in student athletes, the National Federation of State High School Associations called push-ups the “No 1 cause” of rhabdomyolysis. In April, Texas families filed a lawsuit against a charter school after 20 children were hospitalized after hundreds of pushups.

Walrod said collegiate sports professionals became more vigilant about prevention after University of Iowa football players were hospitalized with exertional rhabdomyolysis in 2011. “That case spurred better control of workouts, better monitoring, and better input from the trainers and strength coaches.”

“Where we see most of the cases is that athletes are being pushed or threatened or punished [contrary to industry standards],” said Dr Rebecca Stearns, COO at the Korey Stringer Institute for preventing sudden death in sports. Coaches are not exercise physiologists, and even when well-intentioned may not have adequate training to prevent overexertion, said Boden.

Similarly, there’s no guarantee fitness instructors understand the risk. “People may be going in unconditioned and doing too much too soon,” said Walrod of these classes. CrossFit incorporated prevention into its trainer curriculum after reports of severe cases among participants, but in general, class participants should self-monitor.

How do you identify overexertion?

I was discharged from the hospital with a firm instruction: no exercise except walking for a month. I had to learn what an appropriate challenge felt like – how to self-monitor, discern between safe discomfort and overexertion, and advocate for myself. But when is hard too hard?

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Unfortunately, sensing that something is wrong is a subjective measure; there is no universal metric.

“I never have a very satisfying answer to that, but I do think it’s a line we need to be vigilant about always, and it changes from day to day,” said Dr Natalia Petrzela, author of Fit Nation: The Gains and Pains of America’s Exercise Obsession, longtime fitness instructor, and professor of history at The New School.

“You know your body the best, and if you feel like something isn’t right, it’s time to speak up,” said Walrod. Sports medicine physicians advise people to stop exercise immediately if unusual pain occurs; in the event that there is excessive muscle breakdown, it’s critical to stop the movement right away.

Speaking up in a class setting can be difficult. Many feel self-conscious about pausing or modifying activity, especially if an instructor is singling them out. Petrzela said that she motivates participants in her class but also expresses a key caveat: “Only you know what you can do today.” She said this language “helps [them] find that very important and difficult-to-discern line”, adding that this nuance might get lost in classes with less experienced instructors who give inflexible instructions.


During that fateful class, I ignored the alarm bells. Maybe I was desperately chasing endorphins or wanted to prove to myself that I wasn’t weak. Ironically, my arms atrophied to below baseline as a result.

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Over a year later, I’m still building my strength back – but not at bootcamp. I opt for low-impact methods such as barre and pilates where I can modify if needed, and there is no need to keep pace with others.

Sometimes I tell instructors about my medical history, so they understand what’s happening if I pause. Verbalizing it also reminds me to be careful. Finally, I avoid anything new or especially difficult when I’m having a hard day.

Fitness culture taught me that pain is gain – but now I know that’s not always true.

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